Does CBD work for children with autism?
- A 2019 review suggested that CBD could be a potential candidate as a treatment for Autism Spectrum Disorder(1).
- In a 2018 Israeli study published in Frontiers in Pharmacology, results showed that cannabidiol might alleviate symptoms that are often associated with ASD, such as hyperactivity, aggression, and anxiety, but its long-term effects still need to be studied(2).
- More studies are needed and are being conducted to evaluate the long-term effects, safety, and effectiveness of cannabidiol to children with ASD(3). It is recommended to talk to an expert pediatrician before using CBD as a treatment for children with an autism spectrum disorder.
Why People Are Turning to CBD for Autism
According to a 2018 study published in the journal Frontiers in Pharmacology, parents of children with ASD reported that their kids experienced an overall improvement after taking oral cannabidiol(4).
This study, along with the ongoing clinical trials and research in many countries such as Israel and the United States, resulted in an increasing interest in the possibility of using cannabinoids, particularly cannabidiol, as an additional treatment for autism symptoms and associated illnesses(5).
Common symptoms that are displayed by children with ASD include aggressiveness, restlessness, sleep disorders, and self-injurious behaviors(6). They also manifest hyperactivity and anxiety(7).
ASD includes childhood disintegrative disorder, Asperger’s syndrome, and an unspecified type of prevalent developmental disorder(8).
In the study, the Israeli Ministry of Health gave license to the parents of children with an autism spectrum disorder to administer oral drops of CBD oil to their kids. A nurse practitioner instructed them on how to apply the substance properly(9).
Four ASD symptoms were assessed in the course of the study: hyperactivity, sleep problems, self-injury, and anxiety. The individuals involved were between three and twenty-five years old.
After CBD administration, parents claimed that in general, their kids had a more favorable condition.
Out of the 38 children who had hyperactivity symptoms, 68.4% exhibited an improvement.
Reports on 34 patients who displayed self-injury and rage attacks showed that 67.6% became better.
71.4% of patients with sleep problems were reported to have improved results.
Lastly, reports showed that 47.1% of children with anxiety demonstrated improvement of symptoms.
Researchers of another 2019 retrospective study featured in Scientific Reports looked on the safety and effectiveness of marijuana in 188 children with ASD. The patients, who took three doses of medical cannabis oil with 30% CBD and 1.5% tetrahydrocannabinol (THC) daily for six months, were between 11 and 18 years old(10).
After the treatment period, 30% of the patients had improved significantly, 54% of the children had moderate improvement, 6% gained slight improvement, while 9% showed no change in their symptoms(11).
According to the report, 11 out of 13 ASD pediatric patients with seizures claimed that their symptoms completely disappeared(12).
However, the report showed that 23 patients involved in the study experienced adverse side effects, including restlessness, dry mouth, sleepiness, increased appetite, and psychoactive effect(13).
The researchers of the study concluded, “Cannabis as a treatment in ASD patients appears to be a well-tolerated, safe and seemingly effective option to relieve symptoms, mainly: seizures, tics, depression, restlessness and rage attacks.”(14)
A group of researchers from Shaare Zedek Medical Center in Jerusalem, headed by pediatric neurologist Dr. Adi Aran, also cited their preliminary findings that support the potential use of medical marijuana for autistic children(15).
The team observed 60 children with ASD who were between 5 and 7 years old. The patients were treated with oral cannabis that had CBD and THC cannabinoids at a 20:1 ratio(16).
The study highlighted favorable results. 61% of the patients improved significantly in terms of behavior outbreaks, and 86% improved on communication difficulties(17).
The treatment had mild side effects, though: 14% of the children had sleep disturbances, 9% experienced irritability, and 9% also had a loss of appetite(18).
The results prompted Shaare Zedek Medical Center to launch an ongoing large, double-blind, placebo-controlled clinical trial with 120 participants.
More studies are needed and are being conducted to evaluate the long-term effects, safety, and effectiveness of cannabidiol to children with ASD(19).
In the United States, another clinical trial is underway led by Dr. Eric Hollander at Montefiore Medical Center in New York. The study, Cannabidivarin (CBDV) vs. Placebo in Children with Autism Spectrum Disorder (ASD, started in April 2019 and is expected to conclude in September 2021(20).
To date, Epidiolex, a drug used to treat childhood epilepsy, is the only FDA-approved medicine derived from the cannabis plant(21). Thus, it is recommended to talk to a trusted pediatrician and a CBD expert before using CBD as a treatment for children with an autism spectrum disorder.
The Pros and Cons of CBD Oil for Autism
The Pros
- According to the World Health Organization (WHO), cannabidiol or CBD “is generally well tolerated with a good safety profile.”(22)
- As presented in several studies mentioned above, CBD showed that it could be a possible cure in alleviating symptoms associated with ASD.
The Cons
- There are limited complete studies to assess the safety and efficacy of using CBD to treat illnesses other than the ones authorized by the FDA.
- Brent A. Bauer, M.D., medical editor of Mayo Clinic Book of Alternative Medicine, detailed in an article that CBD may cause reduced appetite, fatigue, dry mouth, drowsiness, and diarrhea(23).
- Peter Grinspoon, MD of Harvard Medical School and author of Free Refills: A Doctor Confronts His Addiction, also warned that CBD side effects include nausea and irritability(42).
- CBD may inhibit the metabolic enzymes of some drugs; thus, it can affect how the body will absorb other medical treatments that are taken together with CBD(25). It is advisable to consult with a licensed professional before adding CBD as part of the medical regimen.
How CBD oil compares to Alternative Treatments for Autism
There is currently no standard treatment for ASD patients, but there are specific medications that can help address the symptoms of autism spectrum disorder(26).
The FDA authorized the usage of antipsychotics like risperidone (for children ages 5 to 16) and aripiprazole (for children ages 6 to 17) to address the irritability linked with autistic disorder(27). These medications could lessen aggression and withdrawal of people with autism.
In addition, selective serotonin reuptake inhibitors (SSRIs) are prescribed to treat conditions often associated with ASD, such as anxiety, obsessive-compulsive behaviors, and depression(28).
SSRIs may minimize the intensity and frequency of repetitive behaviors and reduce anxiety, aggressive behavior, and tantrums.
Likewise, CBD contains anxiolytic (anti-anxiety) properties that could be a potential treatment for several anxiety illnesses and has demonstrated its capability to reduce irritability and hyperactivity caused by ASD(29).
In a 2018 study published in Frontiers in Pharmacology journal, children who received oral cannabidiol treatment improved their self-injury, anxiety, hyperactivity, and sleep conditions(30).
However, further studies are required to solidify the effectiveness of CBD as an alternative medicinal treatment to reduce the symptoms of ASD.
Mayo Clinic outlined some treatment options for autism(31):
- Early intervention can be a big help to develop a child’s communication, social, functional, behavioral, and critical skills. Moreover, identifying the child’s strengths early on may be advantageous to maximize the child’s potential and lessen his or her risk of acquiring more behavioral difficulties.
- Communication and behavior therapies. The programs under these therapies include teaching the kids on how to properly act in social settings or communicate with others.
- Educational therapies. These offer structured educational programs that can improve the child’s social skills.
- Family therapies. The parents and other family members of the patients can study how to interact, play, and deal with their children. These therapies teach helpful daily living skills, managing problem behaviors, and communication.
- Medications to manage the symptoms and related ailments
The FDA advised parents to be cautious about some companies who make inaccurate claims that their products or services can cure autism or other related symptoms. These therapies include Hyperbaric Oxygen Therapy, Chelation Therapies, and detoxifying clay baths(32).
How to Choose the Right CBD for Autism
Despite the anecdotal pieces of evidence that CBD could be a potential cure for autism-related syndromes, it is still best to observe precautionary measures in choosing the right CBD product.
Take note of the following actions before purchasing any CBD commodity:
- Be aware of the laws in the area where the product will be bought and consumed. Some states have specific restrictions regarding the allowable THC content in CBD products.
- Read consumer reviews before buying from an online store. When purchasing from a clinic or a physical store, make sure that it is an authorized CBD seller by the government. Remember to buy from reliable and legitimate brands only.
- Check the additional ingredients. Some products include beneficial ingredients like MCT oils or melatonin. However, there are also CBD products that contain potentially dangerous ingredients such as vegetable glycerin and propylene.
- Identify the right dosage. CBD intake may be low dose or higher depending on the user’s condition.
It is best to consult a medical professional who is also well-versed in CBD to gain proper information and guidance. Sound and expert advice can minimize risks and avoid side effects.
CBD Dosage for Autism
As mentioned above, CBD oil dosage may vary depending on the user’s needs. Proper medical advice is recommended.
Aside from Epidiolex, CBD products are marketed as dietary supplements and not prescribed medications(33). Nutritional and dietary supplements are not regulated by the FDA.
As such, the FDA does not review the safety and efficacy of supplements before they are released to the public. It is advisable to be prudent in checking the label, ingredients, and legitimacy of any CBD brand.
How to Take CBD Oil for Autism (and Why)
CBD Oil Capsules and Edibles
CBD oil capsules and edibles come in various forms: gummies, lozenges, and brownies. They may be taken with food and beverages or be included in the current medication upon the physician’s recommendation.
It could take about 20 minutes to one hour before the CBD oil manifests its full effects that can last between 6 and 12 hours.
For young patients, this is the easiest way to ingest CBD.
CBD Oil Tinctures o Drops
Tinctures and drops are taken sublingually (under the tongue). Their results can be felt within 30 to 60 minutes after CBD oil is taken, and the effects can last for 4 to 6 hours.
CBD Oil Vapes
Vaping CBD oil is one of the fastest ways to ingest CBD. However, it is not advisable for children since the dosage for every inhale may vary. It can be difficult to check if they received an accurate dosage.
Diagnosing Autism Spectrum Disorder
ASD starts in early childhood. Children often display autism symptoms in their first year. To diagnose autism spectrum disorder, the pediatric neurologist or developmental physician looks for signs of developmental delays during regular checkups(34).
Autism spectrum disorder has different levels and symptoms; thus, it is difficult to make a diagnosis. No specific medical test is known to identify ASD. As such, the specialists may perform the following:
- Evaluate the child’s communication skills, social interactions, and behavioral development over time.
- Facilitate tests for your child, which cover speech, hearing, language, social and behavioral issues, and developmental level.
- Rate the child’s performance based on structured communication and social interactions.
- Assess the child using the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Academy of Pediatrics (AAP).
- Recommend genetic testing to determine whether the child has a genetic disorder like fragile X syndrome or Rett syndrome. Rett syndrome, a rare non-inherited neurological disease that may cause loss of speech and motor skills.
Conclusion
Several studies mentioned above stated pieces of evidence that CBD could be a possible cure for autism spectrum disorder. More clinical trials and research are also underway to prove CBD’s potential as a treatment for ASD.
However, because the U.S. Food and Drug Administration has not regulated the use of CBD products aside from Epidiolex and given that there are risks in taking CBD as a medication, it is still fitting to consult a licensed health practitioner before using it.
Since ASD is broad and has varying symptoms and degrees, the treatment of autism should be done upon the doctor’s recommendation.
Further, patients with ASD require a deeper level of support and attention. They may experience challenges as they transition to adulthood and also suffer from other mental health disorders or health issues.
The constant guidance of medical specialists is of great help in terms of the child’s medication and development.
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Poleg S, Golubchik P, Offen D, Weizman A Prog Neuropsychopharmacol Biol Psychiatry. 2019 Mar 8; 89():90-96. doi: 10.1016/j.pnpbp.2018.08.030.
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Barchel, D., Stolar, O., De-Haan, T., Ziv-Baran, T., Saban, N., Fuchs, D. O., … Berkovitch, M. (2018). Oral Cannabidiol Use in Children With Autism Spectrum Disorder to Treat Related Symptoms and Co-morbidities. Frontiers in Pharmacology, 9. doi: 10.3389/fphar.2018.01521
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Ibid.
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Ibid.
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Poleg and Golubchik op. cit.
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Mannion A., Leader G. (2013). Comorbidity in autism spectrum disorder: a literature review. Res. Autism Spectr. Disord. 7 1595–1616. doi: 10.1016/j.rasd.2013.09.006.
-
Anxiety and ASD: Current Progress and Ongoing Challenges. South M, Rodgers J, Van Hecke A J Autism Dev Disord. 2017 Dec; 47(12):3679-3681
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Mayo Clinic. Autism Spectrum Disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928
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Barchel and Stolar op. cit.
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Schleider, L. B.-L., Mechoulam, R., Saban, N., Meiri, G., & Novack, V. (2019). Real life Experience of Medical Cannabis Treatment in Autism: Analysis of Safety and Efficacy. Scientific Reports.
-
Ibid.
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Ibid.
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Ibid.
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Ibid.
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Aran, A., Cassuto, H., Lubotzky, A., Wattad, N., & Hazan, E. (n.d.). Brief Report: Cannabidiol-Rich Cannabis in Children with Autism Spectrum Disorder and Severe Behavioral Problems-A Retrospective Feasibility Study.
-
Aran, A., Cassuto, H., & Lubotzky, A. (2018). Cannabidiol Based Medical Cannabis in Children with Autism- a Retrospective Feasibility Study. Neurology, 90.
-
Ibid.
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Ibid.
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Barchel and Stolar op. cit.
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Hollander, E. (n.d.). Cannabidivarin (CBDV) vs. Placebo in Children With Autism Spectrum Disorder (ASD). Retrieved from https://clinicaltrials.gov/ct2/show/NCT03202303
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What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. (2019, November 25). Retrieved from https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
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Expert Committee on Drug Dependence Fortieth Meeting. Cannabidiol (CBD) Critical Review Report. June 2018. Retrieved from https://www.who.int/medicines/access/controlled-substances/WHOCBDReportMay2018-2.pdf.
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Bauer, B. A. (n.d.). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
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Grinspoon, P. (2019, Aug 27). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476.
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Alsherbiny, M. A., & Li, C. G. (2018). Medicinal Cannabis—Potential Drug Interactions. Medicines, 6(1). doi: 10.3390/medicines6010003
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Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
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Food and Drug Administration. Retrieved from https://www.fda.gov/consumers/consumer-updates/be-aware-potentially-dangerous-products-and-therapies-claim-treat-autism
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K., W., A., B., M., R., N., S., & P., H. (2013). Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD. doi: 10.1002/14651858.CD004677.pub3.
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Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics, 12(4). doi: 10.1007/s13311-015-0387-1
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Barchel and Stolar op. cit.
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Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934
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Food and Drug Administration. Retrieved from https://www.fda.gov/consumers/consumer-updates/be-aware-potentially-dangerous-products-and-therapies-claim-treat-autism
-
Food and Drug Administration. Retrieved from https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
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Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/diagnosis-treatment/drc-20352934